Aly asked
Can you accurately describe every way to safely change to time you take your birth control pills? I don't know if I want to take them earlier in the day or later in the day.
Answer
If you are considering changing the time you take your birth control pills, there are many factors to consider, including type of birth control pill you are taking and whether or not you want to move it to earlier in the day, or later in the day. Below, we discuss every scenario to guide you in how to safely change the time your birth control pill.
We will divide it into two sections. The first section will cover the most common type of pill, the combined hormone pill (i.e. ones that contain both an estrogen and a progestin) and the second will cover the progestin only pill, also known as the "mini-pill".
Changing The Time You Take The Combined Hormone Pill
It isn't uncommon to need to change the time you take your pill. It is important to take your birth control pill at the most convenient time, a time that you will remember and a time that you are able to consistently take it. Consistency is key when it comes to birth control dosing. Missing doses or taking doses at inconsistent times can cause a decrease in their ability to prevent against pregnancy.
If you are looking to change your administration time, but don't want to decrease the effectiveness of your pills, simply follow the instructions below.
Earlier In The Day
Changing your combined hormone birth control pill administration time to earlier in the day is both easy and safe. You simply take it at your new desired time. There is no need to use back-up contraception, such as condoms, when switching to earlier in the day.
You can start earlier in the day, even if you are in the middle of your pill pack. There is no need to wait until you start a new pack. You can feel safe changing to an earlier time at any point in your pack.
As you are not missing doses and are not going to be late in the time you are taking the pill, there will be no decrease in effectiveness.
Below is an example scenario of switching your combined hormone birth control pill to earlier in the day:
- You usually take your pill at 9 PM, when you go to bed.
- You want to change to change that time to 8 AM.
- Take your usual dose at 9 PM, then again at 8 AM the next day. This represents 11 hours between doses.
It is important to remember that you should not skip a day to change your time. Even though in the above example you are only separating your doses by 11 hours, this is safe. You may experience some slight nausea, and uncommonly, some spotting, but in general, you should be relatively free from side effects. Most importantly, your birth control pill will be just as effective.
Later In The Day
If you want to change the time you take your birth control pill to later in the day, recommendations get a little more muddled since you are going to be going past your usual administration time.
The safest way to change the time you take your pill to later in the day is to change to your new time when you start a new pack of birth control pills. This ensures that there will be no decrease in effectiveness. Once you finish your pills, and start a new pack, just start the new pack at your new time.
If you want to change the time you take your pills to later in the day while you are still taking your current pack, this is still possible. Some sources state that you can change the time with no change in effectiveness of the pill as long as it has not been more than 12 hours since your usual dose.
For example:
- You usually take your pill at 8 AM.
- You want to take your pill now at 7 PM.
- Since this is within 12 hours, this is safe and the effectiveness your pill will not decrease.
Some sources however, such as the CDC (Centers for Disease Control), are less strict and state that as long as you take you take your pill within 24 hours of your last dose, there will be no decrease in effectiveness. Below is the graphic from the CDC:
So, it is safe to say that if you want to change your administration time to later in the day, as long as it is within 12 hours, there will be no decrease in effectiveness and there is no need to use back-up birth control. If you follow the CDC recommendation, you are safe as long as you don't allow 24 hours or more to pass between doses.
It should be known that that vast majority of sources state that you are safe as long as you don't allow more than 24 hours to pass between doses. This includes most of the 'patient information' inserts for combined hormone pills.
- For example, the prescribing information for Yasmin, a popular combined hormone pill, states that back-up birth control is not needed as long as you don't go more than 24 hours between doses.
Changing The Time You Take The Progestin Only Pill
Progestin only pills, also known as POPs and as a "minipill", have much less wiggle room than combined hormone contraceptive pills.Taking a progestin only pill inconsistently will almost assuredly decrease the effectiveness of the pill.
Earlier In The Day
Like the combined hormone birth control pills, it is very easy to change your administration time to earlier in the day. You simply take it at your new desired time. There is no need to use back-up contraception, when switching to earlier in the day. As you are not missing doses and not taking the pill later, there will be no decrease in birth control efficacy.
Below is an example scenario of switching your progestin only birth control pill to earlier in the day:
- You usually take your pill at 10 PM.
- You want to change to change that time to 6 AM.
- Take your usual dose at 10 PM, then again at 6 AM the next day.
Even though you are taking doses only 8 hours apart, this is safe. You may experience some slight nausea, but other than that, you should have no issues.
You can start earlier in the day, even if you are in the middle of your pill pack. There is no need to wait until you start a new pack. You can feel safe changing to an earlier time at any point in your pack.
Later In The Day
When you want to take your progestin only pill later in the day, this is where you need to be careful. If you are more than three hours later in taking your usual dose, there is a chance the pill will be less effective. Therefore, you can only safely move your usual administration time by 3 hours or less.
If you want to move your time more than 3 hours after your usual dosing time, you will need to use back-up birth control. Most sources, such as the prescribing information for Ortho Micronor (norethindrone), state that if you are more than 3 hours late, you need to use back-up contraception for at least 48 hours.
As a general rule of thumb, anytime you aren't taking your progestin only pills consistently, it would be a good idea to use back-up birth control. It goes without saying that unintended pregnancy has serious consequences and it is important to be careful.
Lastly, the above recommendation (to stay within 3 hours from your usual dose) still applies, even when you start a new pack of pills. Unlike combined hormone pills, where you have the ability to start a new pack at a new time, this doesn't apply to progestin only pills. Even when starting a new pack, if you take your pills more than 3 hours later than your usual time, you should use back-up birth control.
Additional Information
Remember that the type of birth control pill that you are taking will be a key factor in determining how to safely change your administration time. Be sure to check if you are taking a combined hormone pill or a progestin only pill. The most common progestin only pills are:
- Camila
- Errin
- Heather
- Jencycla
- Jolivette
- Lyza
- Nora-BE
- Norethindrone 0.35 mg
- Norlyda
- Ortho Micronor
- Sharobel
Summary
- There are two different types of oral birth control pills, combined hormone (containing an estrogen and progestin) and progestin only pills.
- Combined hormone pills have more flexibility when it comes to changing the time you take them (see instructions above).
- Progestin only pills have less flexibility when it comes to changing administration time. In general, if you are more than 3 hours late in taking a dose, you need to use back-up birth control for at least 48 hours.
